Abstract: Objective To investigate the relationship between expression of survivin or bcl-2 and chemosensitivities in lymph node metastases (LNMs) and gastrointestinal carcinomas. Methods The chemosenisitivities of tumor cells to 11 drugs were measured by MTT assay, and expression of survivin and bcl-2 were determined immunohistochemically in 54 paired primary tumor (PT) and LNMs of gastrointestinal carcinomas. Results The low accordance (24.1%) in expression of survivin was observed between PT and LNMs（k=0.0634, P=0.4392）. There was no significant difference in either expression of survivin or bcl-2 between PT and LNMs (Z=3.5, 9.5; both P>0.05). The expression of bcl-2 showed a positive correlation between LNMs and PT (r=0.5226, P<0.05). In PT, survivin expression showed positive correlation with bcl-2 (r=0.2937，P=0.0311). The inhibition rates of LNMs cells for HCPT, LOHP, CDDP, MTX and VCR were lower than those of PT (t=2.08~2.48, all P<0.05), and for higher VP-16, THP and MMC were detected (t=2.11~3.06, all P<0.05). There was statistically negative correlativity between expression of survivin and inhibition rates of PT for VCR (r=0.4135, P<0.05), and of LNMs for VP-16 and PTX (r=0.4061, 0.5127; both P<0.05) respectively. Expression of bcl-2 in PT was negative correlation with inhibition rates for 5-Fu and PTX (r=0.4715, 0.3965; both P<0.05), and also in LNMs for VP-16, HCPT, PTX, LOHP and eADM (r=0.4002~0.5644; all P<0.05). Conclusion The LNMs of gastrointestinal carcinomas are heterogeneous with respect to the expression of anti-apoptosis proteins and response to chemotherapy. Effective adjuvant chemotherapy in gastrointestinal cancers depends on targeting the metastatic component of the disease.